Organization
ADVANCED CARDIOTHORACIC SURGERY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI GHEISSARI M.D. (PRESIDENT)
(213) 483-1055
Entity
Organization
Contact information
Practice address
1245 WILSHIRE BLVD, SUITE 606, LOS ANGELES, CA 90017-4810
(213) 483-1055
(213) 483-1418
Mailing address
1245 WILSHIRE BLVD, SUITE 606, LOS ANGELES, CA 90017-4810
(213) 483-1055
(213) 483-1418
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G72926
CA
Other
Enumeration date
08/19/2005
Last updated
09/29/2011
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